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Incidence and multi...
Incidence and multivariable correlates of long-term mortality in patients treated with surgical or percutaneous revascularization in the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) trial.
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Farooq, Vasim (författare)
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Serruys, Patrick W (författare)
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Bourantas, Christos (författare)
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Vranckx, Pascal (författare)
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Diletti, Roberto (författare)
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Garcia Garcia, Hector M (författare)
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Holmes, David R (författare)
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Kappetein, Arie-Pieter (författare)
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Mack, Michael (författare)
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Feldman, Ted (författare)
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Morice, Marie Claude (författare)
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Colombo, Antonio (författare)
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Morel, Marie-Angèle (författare)
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de Vries, Ton (författare)
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van Es, Gerrit Anne (författare)
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Steyerberg, Ewout W (författare)
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Dawkins, Keith D (författare)
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Mohr, Friedrich W (författare)
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- James, Stefan (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),kardiologi
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- Ståhle, Elisabeth (författare)
- Uppsala universitet,Thoraxkirurgi,Uppsala kliniska forskningscentrum (UCR)
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(creator_code:org_t)
- 2012-10-26
- 2012
- Engelska.
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Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 33:24, s. 3105-3113
- Relaterad länk:
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https://academic.oup...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- Aims The aim of this investigation was to determine the incidence and multivariable correlates of long-term (4-year) mortality in patients treated with surgical or percutaneous revascularization in the synergy between percutaneous coronary intervention (PCI) with TAXUS Express and Cardiac Surgery (SYNTAX) trial. Methods and results A total of 1800 patients were randomized to undergo coronary artery bypass graft (CABG) surgery (n = 897) or PCI (n = 903). Prospectively collected baseline and peri- and post-procedural data were used to determine independent correlates of 4-year all-cause death in the CABG and the PCI arms (Cox proportional hazards model). Four-year mortality rates in the CABG and the PCI arms were 9.0% [74 deaths (12 in-hospital)] and 11.8% [104 deaths (16 in-hospital)], respectively (log-rank P-value = 0.063). Censored data comprised 78 patients (8.7%) in the CABG arm, and 24 patients (2.7%) in the PCI arm (log-rank P-value < 0.001). Within the CABG arm, the strongest independent correlates of 4-year mortality were lack of discharge aspirin [hazard ratio (HR) 3.56; 95% CI: 2.04, 6.21; P < 0.001], peripheral vascular disease (PVD) (HR: 2.65; 95% CI: 1.49, 4.72; P = 0.001), chronic obstructive pulmonary disease, age, and serum creatinine. Within the PCI arm, the strongest independent correlate of 4-year mortality was lack of post-procedural anti-platelet therapy (HR: 152.16; 95% CI: 53.57, 432.22; P < 0.001), with 10 reported early (within 45 days) in-hospital deaths secondary to multifactorial causes precluding administration of anti-platelet therapy. Other independent correlates of mortality in the PCI arm included amiodarone therapy on discharge, pre-procedural poor left ventricular ejection fraction, a 'history of gastrointestinal bleeding or peptic ulcer disease', PVD (HR: 2.13; 95% CI: 1.26, 3.60; P = 0.005), age, female gender (HR: 1.60; 95% CI: 1.01, 2.56; P = 0.048), and the SYNTAX score (Per increase in 10 points: HR: 1.25; 95% CI: 1.06, 1.47; P = 0.007). Conclusion Independent correlates of 4-year mortality in the SYNTAX trial were multifactorial. Lack of discharge aspirin and lack of post-procedural anti-platelet therapy were the strongest independent correlates of mortality in the CABG and the PCI arms, respectively. Peripheral vascular disease is a common independent correlate of 4-year mortality and may be a marker of the severity of baseline coronary disease and risk of future native coronary disease (and extra-cardiac disease) progression.
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Farooq, Vasim
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Serruys, Patrick ...
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Bourantas, Chris ...
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Vranckx, Pascal
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Diletti, Roberto
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Garcia Garcia, H ...
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visa fler...
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Holmes, David R
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Kappetein, Arie- ...
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Mack, Michael
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Feldman, Ted
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Morice, Marie Cl ...
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Colombo, Antonio
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Morel, Marie-Ang ...
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de Vries, Ton
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van Es, Gerrit A ...
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Steyerberg, Ewou ...
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Dawkins, Keith D
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Mohr, Friedrich ...
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James, Stefan
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Ståhle, Elisabet ...
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European Heart J ...
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Uppsala universitet